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Health and fairness in London

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In our first year since April 2013, the London Health Commission has been a pivotal programme of work. As PHE’s London Regional Director, I chair one of the Commission’s four groups.  My group is looking at improving health and reducing inequalities in London.  It is an uplifting experience to see how many individuals, groups and organisations want to engage in this discussion about our health and fairness in how our life chances play out in London. Despite being one of the richest cities in the world – and with tremendous educational, technologal, creative and business assets – London has many challenges that affect the health of all of us, and particularly of the most vulnerable. The questions for me are how can we ‘mine’ such wonderful assets, make the best of a beautiful city, bring our own work to bear and use the opportunities that this Commission undoubtedly offers us? After all, this is about realising our children’s future and ensuring London is the city of choice for world-class talent. Increasingly, we recognise that to be that great place London needs to be a good place to live and a place that is known to care about all of its population.

We know some of the health problems. Our work in PHE London has identified that 40% of the cases of TB in England are in London and numbers in England exceed most western European countries.  The rate of overweight or obese children in year 6 is higher in London than in England as a whole. It is also important that Londoners are less content with life than in other parts of England, despite apparently greater wealth and opportunities: what is behind that?  Unfortunately there are also great differences in life expectancy between the richest and poorest in London. PHE London has set about addressing some of these challenges, with and through our partner organisations and academic colleagues and with an interest in finding some solutions.  These have been stubborn problems and require the coordinated efforts of many, but with an ambition to make progress. That is why, in addition to our usual work, the London Health Commission could offer us some imaginative ways forward.

The Commission is an opportunity to bring together the Mayor of London with the NHS, local government and the wider public to address these challenges that London faces. The evidence sessions of the Commission, chaired by Lord Darzi who leads the Commission, have been fascinating. Evidence was taken from a wide variety of individuals: from the founder and director of Kids Company, Camila Batmanghelidjh CBE to Commissioner of Transport for London Sir Peter Hendy. A summary of the evidence to date is published today (Monday 31 March 2014) and I would recommend a viewing it.

I was tasked with examining what more can be done to support and engage people in managing their own health and care to reduce health inequalities. I am conscious of drawing on good practice from the UK and overseas. Cities internationally are now recognised as significant innovators in heath improvement. London can learn from other cities and we can compare London in terms of health, health inequalities, healthcare and the healthcare economy with other global cities such as New York, Paris, Tokyo and Sao Paulo.

Good folk have offered their expert advice on these topics and we have looked at a range of issues from personal behaviour through to the impact of wider determinants of health, such as the environment of the city, and the role of various interests that contribute to this vibrant capital. How can we better engage and help support people in their responsibility for their greatest personal asset – their own health? We are still looking at a range of evidence.

I recently spoke at a conference on compassion in practice. I thought hard about what this meant for a city like London and our work in PHE for the public’s health. I was particularly thinking about the work of the Commission too. London can be a very compassionate city. Some of the messages I would suggest through our work for the public’s health are:

  • As you take responsibility for your health, we will do our part by creating supportive environments towards that.
  • We work constantly to ensure that London is an inclusive city; one where body and mind work together.
  • We are working with many interests to help young people build their personal resilience.
  • We also want to help families and guardians make the best choices for their children and support the more vulnerable young people.
  • People are also increasingly ageing in London and it will need to become a friendly city for older people. We all must work for that.

The Commission will now work up its recommendations over the summer for final publication in the autumn. I hope our final report will be a landmark one for London’s health, engaging Londoners to set out the path for a future healthier London. In the meantime, you might want to keep an eye on the Commission’s website to read the summary of evidence and for the latest news and any emerging updates from the Commission.

Featured image by Wojtek Gurak. Used without modification under Creative Commons license.

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1 comment

  1. Comment by Bren posted on

    Hello Yvonne,

    A really great and informative blog. You are a very key and important link, in so many ways, to the Commission and to this work. You must all provide leadership, which I know you will, and your emotional intelligence and system leadership will shine throughout.

    My thoughts on this work is that sometimes we have a view of interventions and programmes early, but seeing how a great local community friend of mine works, she starts in the early- early stages of work with vulnerable people.and where they are at (and no where people think they are at).

    You are, will, and will always continue to do great work.

    Best wishes,